What is outpatient care?

Today your options for where to get your medical care are greater than ever before. You may not even have to leave your home to get the care you want and need. You can choose based on what your health problem is and what works best for you. And you don't have to use one option for all your health care needs. You can choose where to seek care based on what will work best for you in that instance.

When you have a serious problem that needs care right away, an emergency room (ER) is the best place to go. ERs are set up to handle problems that may be life-threatening. And ER staff are skilled at giving care that can save lives. Emergencies include problems such as:

• Heart attack or stroke symptoms.
• Severe bleeding.
• Severe trouble breathing.
• Severe pain.

If you don't believe you have a need for emergency care, you can think about what's most important to you on a case-by-case basis. Sometimes, convenience and speed might drive your decision. In other cases, the cost of care matters most. And in some cases, you may believe it's better to see a health professional who knows you and your history.

Your primary care provider has the advantage of knowing your health and medicine history. Your doctor may know about your health habits, such as diet and exercise. Your doctor often knows your home, work, and family situation. But the office location or hours may not always work for you. And your doctor may not provide care for something urgent like broken bones or stitches.

After you decide what is most important to you, you can choose your care option. The number of choices varies by community. But there are more and more options available in health care, such as urgent care clinics, retail clinics, and virtual care.

Urgent care clinics are usually able to provide care for problems like sprains, burns, and broken bones. They also do X-ray tests, throat cultures, and routine health care, such as sports physicals and shots. These clinics often can be found in neighborhoods and near shopping areas. You may be able to just walk in to see someone. Or you may be able to set up an appointment online. Care at an urgent care clinic usually will cost less than at an ER.

Retail clinics are often in drugstores or supermarkets. These clinics can handle less serious problems like urinary tract infections and minor cuts. They also do health screenings and flu vaccines. You can usually just walk in or set up an appointment online. Retail clinics can cost less than ERs, urgent care clinics, or your primary doctor.

Urgent care and retail clinics can be a great option if you can't or don't want to wait to see your own doctor. They can also be a good option if you don't think you need the level of care an ER provides. With an urgent care or retail clinic, you likely will see a health professional you haven't seen before.

Try to find out all you can about the outpatient center before you use it. It's a good idea to visit the center before you decide.

Many health and government agencies rate or report on the quality of outpatient centers. Check with your state's board of medicine or with your insurance company to learn more.

You can also look up outpatient centers on these websites:

• Care Compare from the Centers for Medicare and Medicaid Services at www.medicare.gov/care-compare
• Quality Check from The Joint Commission at www.qualitycheck.org

Outpatient services are medical procedures or tests that can be done in a medical center without an overnight stay. Many procedures and tests can be done in a few hours. Outpatient services include:

• Wellness and prevention, such as counseling and weight-loss programs.
• Diagnosis, such as lab tests and MRI scans.
• Treatment, such as some surgeries and chemotherapy.
• Rehabilitation, such as drug or alcohol rehab and physical therapy.

Most people can choose an outpatient center instead of a hospital if the needed service is available. But not all medical procedures can or should be done at an outpatient center.

Outpatient services usually cost less because you don't need to stay overnight. Staff members at outpatient centers are well trained in the service they provide. Most of the time, these centers specialize in one kind of treatment or procedure. Often all the care you need can be provided in one place.

It is important to check with your health insurance provider to determine what outpatient services are covered. Your particular health plan coverage may limit your choice of services.

Choosing a quality outpatient center before you have a medical procedure is a good way to make sure that you'll receive excellent care. Friends and family who have used outpatient services may tell you about their personal experiences. Often your doctor will know about the quality of outpatient services in your area. You may want to start your search by talking with your doctor about your options. Next, find out which outpatient services are covered by your insurance company. The following questions may help you find the outpatient service center that best fits your needs:

• Does the facility accept your health insurance? Does your insurance cover any or all of the costs?
• Is the outpatient service center conveniently located or within a reasonable distance of your home or work?
• Is more than one facility in your area qualified to provide the service you need?
• Will the facility communicate well with your doctor and provide the information you need in a timely manner? Can your doctor verify the accuracy of any tests you had?
• Is the outpatient service center accredited by a national medical board or other recognized agency? You can find out by calling your state medical board or The Joint Commission.
• Is the facility clean, organized, comfortable, and private? You'll need to visit the facility to find out. You may want to ask the facility or others who have used the facility if the recovery room is well-staffed. Is there a waiting room for your family?
• Is information readily available to you? Will you receive instructions before, during, and after a procedure or test?
• Are brochures or literature available that explain the outpatient center's services and fees? Does the facility provide information on financial assistance?
• Do you have other health conditions that should be considered? Can the facility accommodate treating your other conditions if needed? Does your doctor think there is a risk that you may need specialized attention or emergency services during the procedure?
• Does the center have all of the possible equipment and knowledge it needs to treat you in case of an emergency during your procedure, test, or surgery—such as problems with anesthesia during surgery or your newborn needing intensive care after delivery? If you have other health conditions, you may be at higher risk for needing emergency care.
• Is the center connected to a major hospital, in case you need emergency care. How far away is the hospital?
• Can you get all the care you need at the facility? Will the center provide all the medicines or other treatment needed? Will you have to go somewhere else for follow-up care?
• What kind of experience does the staff have? How long has the outpatient service center been operating? What are the specialties of the doctors providing the care? Are they board-certified in their specialty areas?

You may have more questions based on your own health issues and the type of procedure or test you need. Ask questions, listen to the recommendation of your doctor and those you trust, and visit the facility to get the information you need to make the best decision for your health care.